What is the menopause?
The menopause is a natural biological event that all women go through usually in their 40s or 50s. As women age, their fertility decreases until it eventually stops. This process is an actual biological process that mainly concerns changes in levels of certain hormones, particularly oestrogen. Oestrogen is mainly produced in the ovaries and when women reach a certain age their ovaries begin to stop producing oestrogen, as oestrogen levels decrease a woman will experience a change in their monthly periods, whereby they become irregular and eventually stop.
However, the process of this change means hormone levels can fluctuate, these fluctuations in hormone levels can cause much discomfort to women as they experience various different usually unpleasant, symptoms. Some symptoms experienced include; hot flushes and night sweats, fatigue, memory problems (brain fog), urinary problems, vaginal dryness, psychological problems such as anxiety and depression, headaches, sleep disturbances and joint and muscle weakness. This list is not exhaustive and falling oestrogen levels can cause all sorts of symptoms in women.
Eventually a woman’s ovaries stop production of oestrogen altogether, normally this can take some years from the first signs of entering the menopause, and usually women can start to experience a reduction or cessation of the unpleasant symptoms.
What can be done naturally to help reduce menopause symptoms?
This is the holy grail! There are no hard and fast ways to stop the unpleasant effects of the menopause, unless of course you choose to take hormone replacement therapy (HRT). A prescribed medication that delivers hormones to the body via various means such as tablet form, skin patch or gel. Many women report how much better they feel after starting HRT, stating that hot flushes, headaches, fatigue etc. are reduced or even stopped after starting this therapy. There are also other biological benefits such as a reduction in bone demineralisation caused by oestrogen reduction.
BUT, there is evidence to suggest that women who have had oestrogen positive breast cancer are potentially at higher risk of it returning, if they take HRT because of the increased circulating oestrogen. Also some women, for their own reasons would prefer not to take hormone therapy and would like to have a more natural approach to dealing with the symptoms.
Helping reduce the effects of the menopause in a natural way is not a single activity, and I would recommend adopting as many of these healthy lifestyle choices as possible so you have a combined effect. There is also the added benefit that many suggestions to help alleviate the effects of the menopause are good health choices to make anyway, so have other benefits to the body.
You will hear this again and again when it comes to health, in all forms. Eat a healthy, varied balanced diet. What does that mean? Follow the advice of Public Health England and the Eatwell Guide.
- Eat at least five portions of fruit and vegetables every day. Make them varied and colourful to get the best mix of nutrients
- A third of your plate should be starchy carbohydrates, but stick to wholegrain varieties such as wholegrain rice, pasta and bread for example. Your fibre intake should be 40 g per day.
- Eat a small amount of lean protein. This can be animal or plant based, but there is evidence to suggest that a plant based diet is not only healthier, but also environmentally friendly. Don’t feel guilty for eating meat, but try not to eat processed meat such as ham, bacon, sausages etc., or have more than one portion of red meat a week. Try to have two portions of fish a week, one being an oily fish such as salmon or mackerel.
- Use only very small amounts of fat, but make it a vegetable based fat such as olive oil or sunflower oil rather than saturated fats such as butter, lard, even coconut oil.
- Keep your intake of salt to max 6 g per day and sugar no more than 7 teaspoons (including in cakes and biscuits).
- Try not to snack on chocolate and sweet treats if you can and substitute them for a piece of fruit or veg sticks and a nice dip such as houmous. I know this is difficult when you are not feeling great.
- Drink plenty of water!
Calcium and vitamin D
There are some specific dietary needs for the menopausal woman! Due to the reduction in oestrogen, bones can become demineralised and hence thin and brittle. It is therefore important to ensure calcium and vitamin D intakes are optimised. What does that mean? Menopausal and post-menopausal women need to eat food rich in these nutrients such as dairy products (milk, yoghurt, cheese) or fortified foods such as soya milk, cereals, margarine. Vegans should eat plenty of green leafy vegetables, almonds and calcium set tofu. The best way to get vitamin D is via sunlight, so during the summer months’ women should try to get around 10-15 minutes of sunlight on a patch of their bare skin (no sunscreen) every day. During the winter months it is recommended that all adults take a vitamin D supplement of 10 µg/day.
Stop or greatly reduce your alcohol intake
There is no hard evidence that alcohol intake has a direct cause or effect on the symptoms of the menopause, however it can sometimes intensify some of the unpleasant side effects, such as hot flushes. Also, excess alcohol causes weight gain and this has health implications for post-menopausal women, as it has an additional increase in risk of cardiovascular (high blood pressure, heart attack and stroke) disease and osteoporosis.
In general consuming alcohol in excess (above 14 units a week), will have short and long term effects on your health, with too much alcohol only adding to the effects of the menopause as well as increasing the risk of other diseases. My advice would be to cut alcohol intake to one or two units per week maximum. You will feel better for it, trust me.
Giving up smoking if you are a smoker is the single best thing you can do for your general health. For women going through the menopause smoking can increase the risk of cardiovascular disease and osteoporosis, as well as intensifying the effects of hot flushes, headaches and night sweats associated with the menopause. Smokers also tend to start the menopause up to two years earlier than non-smokers.
Maintain a healthy body weight
Obesity and overweight is now becoming a serious health issue in the UK and it is predicted that it will eventually overtake smoking as the cause of death from many cancers and other weight associated diseases. As we age our metabolic rate naturally decreases, so even if we are eating in the same way as when we were at a younger age, we will naturally gain weight. We are also becoming as a nation more sedentary and over consuming calories. Less exercise, more food and ageing combines to increase our weight.
Switching away from unhealthy foods and really taking care of what you eat as described above from the Eatwell Guide will make sure you are consuming nutrient dense foods. Keeping track of your calorie intake will also ensure you don’t over eat. Women should consume around 2000 kcal per day and men 2500 kcal per day. This is easily done by eating three main meals and a few snacks. So make your meals count and eat a range of fruit and vegetables, lean protein and wholegrains, and healthy snacks
This is where the magic happens! If you are reading this as a menopausal woman, I know how you feel. Exercise is the last thing you want to do! You are tired, your joints hurt, you feel ‘fat’, you have a headache etc. etc. Trust me exercise will make you feel better. Exercise has a million benefits not just to the menopausal woman but for anyone (at least those who are physically able to exercise). Let me list the benefits:
1. A reduction in menopausal symptoms such as weight gain, sleep disturbances, hot flushes
2. The endorphins released in the brain as a result of physical activity just make you feel good.
3. If you can exercise outside even better – being outside has positive effects on your mental health especially anxiety and depression. If you can exercise in a park, forest/wood, near the sea, up a hill/mountain, then the benefits to health are all positive
4. Improvement in your bone health due to the impact on the ground of exercise or other resistance exercise.
5. Reduction in cardiovascular disease risk
It is recommended that we exercise at least 150 minutes of moderate intensity aerobic activity a week, plus muscle strengthening activities on two days or more of the week. Or 75 minutes of vigorous intensity aerobic activity plus muscle strengthening activities two days or more of the week.
Moderate activity should raise the heart rate and make you breathe faster and feel warmer, whilst vigorous exercise should make you breathe hard and fast. Weight bearing exercises can include brisk walking, running, tennis, dancing, and resistant exercises can include lifting weights and press-ups for example.
Are there any benefits from taking supplements?
It’s useful to say here that some people find supplements work for them in controlling or reducing menopausal symptoms, whilst others experience no benefits. I will only advise what the research had found so far. Two main supplement types are herbal remedies and dietary supplements.
A review by Zhu, Liew and Liu (2016) found that Chinese herbal remedies for treating the symptoms of the menopause had no effect in alleviating hot flushes or night sweats, and in fact caused some unpleasant side effects such as mild diarrhoea, breast tenderness, gastric discomfort and unpleasant taste. A review by Leach and Moore (2012), about whether black cohosh was effective at alleviating the effects of the menopause on pre and post-menopausal women, found that there was insufficient evidence to support the use of black cohosh for menopausal women, but did suggest that there was adequate justification for conducting further studies in this area.
A review by Lethaby et al. (2012) found that the use of phytoestrogens did slightly reduce some symptoms of the menopause, particularly hot flushes and night sweats. Phytoestrogens are plant based substances which can be found in foodstuffs such as soya beans, legumes, lentils, chickpeas, tofu, cereals and some fruits and vegetables, that can behave in a similar way to human oestrogen in the body. The authors found that genistein (a substance derived from soy) appeared to reduce the amount of daily hot flushes and suggested further investigation into this substance was needed.
The message here is to not rely on obscure herbal remedies to help with reducing the symptoms of the menopause but to follow a healthy balanced diet rich in fruit and vegetables, maintain a healthy weight, don’t smoke and try not to drink alcohol, but if you do keep it to an absolute minimum and exercise – outside if possible!
If you want some help and support you can contact me via my website www.wellbeingnutrition.co.uk
British Nutrition Foundation (2016). Menopause. Online at https://www.nutrition.org.uk/healthyliving/lifestages/menopause.html
Leach, M. J., Moore, V. (2012). Black cohosh (Cimicifuga spp.) for menopausal symptoms. Cochrane Database of Systematic Reviews. Issue 9. Art. No.: CD007244. DOI: 10.1002/14651858.CD07244.pub2.
Lethaby, A., Marjoribanks, J., Kronenberg, F., Roberts, H., Eden, J., Brown, J. (2013). Phytoestrogens for menopausal vasomotor symptoms. Cochrane Database of Systematic Reviews. Issue 12. Art. No.: CD001395. DOI: 10.1002/14651858.CD001395.pub4.
Zhu, X., Liew, Y., Liu, Z, L. (2016). Chinese herbal medicine for menopausal symptoms. Cochrane Database of Systematic Reviews. Issue 3. Art. No.: CD009023. DOI: 10.1002/14651858.CD009023.pub2.